This proposal sets forth a plan for further development of UMAC. The overall objectives include: 1) basic and clinical research dealing with the pathogenesis and treatment of the major rheumatic diseases; 2) expansion of education/training programs for physicians and other health professionals to meet the academic and patient care needs in the field; 3) development of new education programs for patients and their families; 4) expansion of a unique program of community-based education for primary care physicians and other health professionals; and 5) evaluation of each education effort by the best available methodologies. Established research programs will be complemented by 8 new pilot research projects that deal with: osteoarthritis, purine mediated immunodeficiency, rheumatic inflammation, immune complex disease (SLE); pharmacokinetics of penicillamine, reovirus arthritis, immune mediated responses of monocytes, and nonsteroidal drug effects on cell mediated immunity. New educational projects are designed to provide training for primary care physicians, assess patient outcome(s) as they are influenced by different models of trainee education/health care delivery, emphasize educational modules for specific allied health professional groups, patients, and their families in the areas of adult and pediatric rheumatology. Several of these educational programs will complement novel community programs in continuing medical education (CME) for primary care physicians ("Educational Influentials", EI's) to disseminate knowledge and skills critical to management of rheumatoid arthritis and osteoarthritis (new project) which will expand the EI concept to include allied health professionals in the intervention strategies. Data will continue to be gathered relative to the frequency and quality of care of RA and OA in the target communities. The Administrative Component of UMAC is integrated into the established organization of the University. It has three Special Core Units: Evaluation, Leuko/plasmapheresis, Tissue Culture, which support specific programs in the education and research components of the Center. UMAC has the required institutional support, professional, physical, and patient resources to achieve its stated objectives.